Physician Compare National (NPI:1093702425)

HEALTHCARE PROVIDER: SANG H SONG SR. MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1093702425
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1557253366
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040326000733
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SONG
	Individual professional last name
Provider First Name	SANG
	Individual professional first name
Provider Middle Name	HUN
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	RUTGERS R W JOHNSON MEDICAL SCHOOL (CAM/NEW BRUNS/PISC)
	Individual professional's medical school
Graduation Year	1996
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL MEDICINE AND REHABILITATION
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	700 PATCHOGUE YAPHANK RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 49
	Group Practice or individual's line 2 address
City	MEDFORD
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	117632239
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y